Organization
TENESHA A BAZEMORE O.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TENESHA BAZEMORE O.D. (DR./OWNER)
(757) 470-0789
Entity
Organization
Contact information
Practice address
6111 JEFFERSON AVE, NEWPORT NEWS, VA 23605-1511
(757) 470-0789
Mailing address
PO BOX 1612, NORFOLK, VA 23501-1612
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000570
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548314388
NPI
VA
Enumeration date
11/17/2017
Last updated
11/17/2017
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